Almost 70% of large counties in the US have elevated levels of COVID

There are over 3000 counties in America. Most of them are very small in size. There are, however, 594 with a population of 100,000 or larger. Of these 408 have elevated levels of COVID. Thats 69%.

We know from mainstream reporting that the US has crossed over 10 million cases, and that new new cases are well over 100,000 per day. But, unlike in the early states of this pandemic – don’t be lulled into a belief that this is happening somewhere else. Its happening everywhere.

Here’s the list of the 408 counties. But before we dive in – consider this.. when I ran this data on September 9th – there were only 75 counties on the list spread across 26 states. Today 45 states have counties that meet the criteria (population >100,000 and daily new cases >200 per million per day.

Ohio wasn’t even on the list in September. Today it is the #1 state for number of counties on the list (27 in total).

10 counties with highest daily new cases

State	County	New Cases per million	New Fatalities per million	County Pop	Coping With Covid
Texas	El Paso	2184	12	839,238	14379
Iowa	Linn	1778	3	226,706	1057
Illinois	Kankakee	1775	6	109,862	521
Iowa	Black Hawk	1562	4	131,228	840
Wisconsin	Marathon	1540	21	135,692	2384
South Dakota	Minnehaha	1533	7	193,134	3150
Wisconsin	Fond du Lac	1412	8	103,403	1723
Texas	Potter	1405	27	117,415	1396
Wisconsin	Eau Claire	1376	15	104,646	1114
Iowa	Scott	1353	3	172,943	1142

Top 10 counties by daily fatalities (per capita)

State	County	New Cases per million	New Fatalities per million	County Pop
Georgia	Lowndes	273	35	117,406
Texas	Potter	1405	27	117,415
Pennsylvania	Schuylkill	325	24	141,359
Illinois	LaSalle	1252	22	108,669
Illinois	Macon	1144	22	104,009
Ohio	Wood	413	22	130,817
Wisconsin	Marathon	1540	21	135,692
Arizona	Navajo	388	21	110,924
Michigan	Calhoun	783	19	134,159
New Mexico	Doña Ana	885	18	218,195

To put this into context – seasonal flu is less than 1 death per million per day.

New York City

Even New York City, a city that suffered greatly and quickly got its act together is experiencing a worrying surge of cases:

El Paso Texas: the highest levels of COVID for a large county

We thought July was bad across the sun belt. In Octover – El Paso, Texas had about 3x the number of cases as in July. November is well on pace to exceed that.

North Dakota Invokes Crisis Management Playbook

The big news for me this week is that North Dakota issued an order to let medical workers who have COVID, but who are asymptomatic, continue to work. Think about that – the medical team that treats you may also have COVID at the same time. They explained this is part of the CDC Crisis Management playbook. Just that fact alone means we are in a full crisis.

North Dakota has a rapidly increasing fatality rate – over 20 fatalities per million per day – and a case load still growing rapidly.

Don’t think this is a problem in another county. Its rapidly spreading across all counties.

Don’t think we can take our time. Learn from El Paso – this can get out of line very rapidly.

Don’t assume we have the medical capacity to address this. In my City – ICU capacity is less than 10%. Learn from North Dakota which is running from the Crisis Management Playbook.

Heading into Thanksgiving – be especially cautious. Now is not the time to relax our vigilence.